Parasympathomimetics Flashcards Preview

Pharmacology > Parasympathomimetics > Flashcards

Flashcards in Parasympathomimetics Deck (50):
1

Cholinergic agonist

Pupil constrict, heart decrease, vasodilation, bronchoconstriction, increase GI, urinary bladder constriction

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Cholinergic receptor agonists chemicals

Acetylcholine, methacholine, carbachol, pilocarpine, betanechol

3

Acetylcholinesterase inhibitors

Edrophonium (tensilon), Physostigmine (Eserine), Neostigmine (prostigmin), Pyridostigmine (mestinon), Rivastigmine (excelon), Donepezil (aricept), Galantamine (razadyne), insecticides, nerve gases

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Cholinergic receptor agonists info

Drugs that directly activate either nicotinic or muscarinic receptors

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Many drugs that have anticholinergic activity effect?

patients with glaucoma, BPH, Alzheimer's

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Clinical uses of cholinergic receptor agonists

Very limited because of side effects

7

Open angle glaucoma

permits opening of canal of schlemm when ciliary muscle constricts for aqueous drainage, most common form, responds to therapy

8

Closed angle glaucoma

a physical obstruction of the canal, even muscle contraction the canal cannot be opened, does not respond to medication, can be emergency

9

Acetylcholinesterase Inhibitors

Blocks acetylcholinesterase will increase concentration of ACH in synapse, similar result of receptor agonist; increase GI, relax bladder sphincter

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Adverse drug reactions of acetylcholinesterase inhibitors

SLUD; salivation, lacrimation, urination, defecation; increase sweating, bradycardia, hypotension, miosis

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Adverse drug reactions of acetylcholinesterase inhibitors

SLUD; salivation, lacrimation, urination, defecation; increase sweating, bradycardia, hypotension, miosis

12

Eprophonium (tensilon)

rare, primarily used for diagnosis myasthenia gravis, given IV, short acting, pt with mg will have improvement when given this drug

13

pyridostigmine (Mestinon)

Reversible, for treatment of myasthenia gravis, PO

14

Neostigmine, Physostigmine

Used by anesthesiologists for reversal of neuromuscular blockers, IV or IM; reverse paraysis

15

Pralidoxime (Protam)

a cholinesterase reactivator, used for pesticide or nerve gas poisoning, most effective if given within hours of exposure, rarely used

16

Atropine

Given IV, can be used for reversal of any AchE inhibitor

17

Alzheimer's disease

loss of cholinergic neuronal activity has been identified as a contributable cause of cognitive decline, AchE have become mainstay in therapy, hope to slow progression

18

Tacrine (Cognex)

first AchE inhibitor available, still on market but never used; causes liver damage

19

Tacrine (Cognex)

first AchE inhibitor available, still on market but never used; causes liver damage

20

Donepezil (aricept)

mild-severe alzheimer's (dif dose), no dose adjust for hepatic or renal, ADR's: incomnia, weight loss

21

Galantamine (Razadyne)

mild to moderate Alzheimer's, PO only, dose adjust for renal and hepatic, Drug Interaction increase activity of galantamine

22

Rivastigmine (Exelon)

Mild-severe Alzheimer's (same dose), Parkinson's dementia (same dose), adjust for renal and hepatic; transdermal thought to be beneficial for compliance and less adr's

23

Parasympatholytics are more commonly called

anticholinergics, very common

24

Action of anticholinergics

act as competitive antagonists at muscarinic receptor site on post ganglionic neurons

25

Types of parasympatholytics

Atropine, scopolamine (Transderm), Dicyclomine (bentyl), hyoscyamine, Glycopyrrolate (Robinul)

26

Anticholinergic eye medications

Atropiine, cyclopentolate, phenylephrine (cyclomydril), tropicamide (Midriacyl)

27

Anticholinergic heart uses and medications

For short term management of bradycardia; Atropineand glycoprrrolate (Robinul)

28

There are no clinical uses for which anticholinergic

Sweat gland and blood vessels

29

Anticholinergic salivary gland uses and medication

inhibits secretion of saliva; Atropine and glycopyrrolate

30

Anticholinergic urologic use

Urinary incontinence; Tolterodine, Oxybutynin, solifenacin, darifenacin, trospium, fesoterodine

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Oxybutynin (ditropan)

manage overactive bladder, no dose adjust for hepatic or renal, ADR: dry moouth, dizziness, constipation

32

Oxybutynin (ditropan)

manage overactive bladder, no dose adjust for hepatic or renal, ADR: dry mouth, dizziness, constipation

33

Tolterodine (Detrol)

long acting, overactive bladder, adjust for renal and hepatic; ADR: dry mouth, HA, constipation; some drug reaction

34

Solifenacin (Vesicare)

overactive bladder, caution with renal and hepatic, ADR: dry mouth, constipation; DI: grapefruit juice; appealing for dementia pts

35

Darifenacin (Enablex)

overactive bladder; no adjust for renal, adjust for hepatic; ADRs: dry moouth, HA, constipation; preferred with dementia

36

Trospium (sanctura)

Overactive bladder, adjust renal, none for hepatic; ADR: dry mouth; VERY expensive

37

Fesoterodine (Toviaz)

Overactive bladder; adjust renal and liver; ADR: dry mouth; some DI, Very expensive

38

Anticholinergic respiratory use and medication

use for asthma, COPD; atropine, glycopyrrolate

39

Ipratropium (atrovent)

asthma, COPD; inhaler or nebulizer; no renal or hepatic, no DIs, no ADRs; Frequent dosing because of short half life

40

Tiotropium (spiriva)

Long acting, COPD only, once daily, dry powder inhaler; new to market, $$

41

Aclidinium (Tudorza)

Only COPD, twice daily, new product $$

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Aclidinium (Tudorza)

Only COPD, twice daily, new product $$

43

Anticholinergic GI uses and medication

cramping, diarrhea, IBS; dicyclomine, hyoscyamine

44

Dicyclomine (Bentyl)

Antispasmodic, IBS and cramping; Adr: drowsiness, dizziness, dry mouth, blurred vision; old drug, cheap

45

Hyoscyamine (anaspaz, Levsin)

GI, preferred for peds, common adrs, old, cheap

46

Anticholinergic CNS uses

restores balance of neurotransmitters, Parkinson's, prevent motion sickness

47

Benztropine (Cogentin)

use for EPS, anti-psychotics, ADR: agitation, HA, constipation, dry mouth, Tachycardia etc, old cheap

48

Trihexyphenidyl (artane)

CNS, ADRs: significant constipation, tachy, etc, old, cheap

49

Scopolamine (transderm)

Motion sickness, patch, OTC, ADRs: drowsiness, blurred vision

50

Glycopyrrolate (Robinul)

Neuromuscular, IV ADR: HA, vomiting, dry mouth, constipation